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Pod Corner: 'Imminent Danger'

SCOTT DETROW, HOST:

In 2016, Amy Lam was a 34-year-old journalism student in New York City. She'd recently moved there from Hong Kong and was expecting her second child. But hours after giving birth, Amy died at Harlem Hospital. Her tragic story is the starting point of a new investigative podcast series from member station WNYC called Imminent Danger: One Doctor And A Trail Of Injured Women. The podcast looks at the troubling medical career of an OB-GYN named Thomas J. Byrne and what it tells us about how doctors are vetted in the United States. The host of that series is WNYC's investigative editor, Christopher Werth. He joins us now. Hey, Christopher.

CHRISTOPHER WERTH, BYLINE: Hey, Scott.

DETROW: So tell us more about how Amy died and how this doctor, Thomas Byrne, treated her on the night that she did die.

WERTH: Yeah. So Amy gave birth at home. She hadn't planned to do that, but that's how it ended up. She had given birth to a healthy baby boy, but her husband had called an ambulance to get some help cutting the umbilical cord. And when EMS arrived, they realized that the placenta had not come out, and so they had transported her to Harlem Hospital. And what we know from medical records is that while she was there, she had started to lose a lot of blood.

And, you know, I want to stress, there were a number of doctors who treated her there to try to stop that bleeding over the course of many hours that night. And one of them was a doctor who was the subject of this series, as you say, Dr. Thomas Byrne. He performed a hysterectomy on Amy just hours after she'd given birth, and he was named in a lawsuit, along with several of those other doctors brought by Amy's family, claiming that her death was wrongful. And that case eventually settled for $3 million.

DETROW: And this is where the series broadens out because your team found that it was pretty remarkable that Byrne was practicing there to begin with, right? Because many years before, he had been stripped of his medical license in New York state in a pretty public way.

WERTH: Yeah. So the New York Health Department had investigated Byrne while he was practicing in upstate New York in the 1990s. It had found five cases over the span of just a couple of years in which his care as an OB-GYN had, as the state said, quote, "caused or contributed to bad outcomes." Three of those babies died. Two were severely injured. The state labeled Byrne an imminent danger to the public initially and then finally revoked his medical license. But what we know is that he was able to keep practicing in other states. He went to New Mexico, and then he went to Oklahoma. And then he ultimately got that New York license back decades later, despite a track record of malpractice lawsuits and disciplinary measures taken against him in those other states. And that's part of what we set out to answer here is how and why he was able to continue practicing.

DETROW: As part of that, your team talked to some of the families who lost babies. What did you learn?

WERTH: Yeah. The reporter on this series, Karen Shakerdge, contacted and spoke with many of the families that were involved in the state's initial investigation. Many of them were angry to find out that Byrne had gotten his license back in New York. She also spoke with a nurse who had worked with Dr. Byrne at the time that those cases happened. Her name is Michelle Durham (ph). I just want to play you a clip from the second episode in the series.

DETROW: OK.

WERTH: You'll first hear our reporter, Karen, and then Michelle.

KAREN SHAKERDGE, BYLINE: Were you there in the room when all of this was unfolding?

MICHELLE DURHAM: Yes.

SHAKERDGE: Michelle Durham was a labor and delivery nurse at the time.

What was it like in there?

DURHAM: From what I recall, I had an impending feeling of - I don't want to sound dramatic, but - doom. Like, this is not going the way it should. Her temperature started to creep up. She developed fetal tachycardia. And she wasn't showing the cervical change that she should have. And I, you know, I think that when you do something in medicine long enough, you develop like a sixth sense. And there are certain cases and bad outcomes specifically you just don't forget.

SHAKERDGE: Can you describe Dr. Byrne? I mean, I'm interested in what your impressions of him were.

DURHAM: I would say, compared to the many physicians I had worked with - I don't know how to say this. You know, he was kind of a cowboy. He would just be much more aggressive in the care of a patient. And I think it made a lot of people uncomfortable.

SHAKERDGE: Michelle also testified as a witness in the investigation into Dr. Byrne.

DURHAM: So prior to the case in question, he already sort of had an established reputation. I mean, because Patient E, whose case I was involved in, was not the first bad outcome. I mean, there had been many previous bad outcomes.

DETROW: That's part of a WNYC podcast called Imminent Danger: One Doctor And A Trail Of Injured Women. I'm speaking to the podcast host, investigative editor Christopher Werth. And, Christopher, this series focuses on one doctor, but it also gets into much bigger systemic issues here about how doctors are vetted and licensed in this country.

WERTH: Yeah, it does. You know, one of the things we looked at is the work that state medical boards do to examine a doctor's track record before granting doctors a license. You know, medical boards really are the first line of defense when it comes to patient safety. But because each state handles its own licensing, a doctor can lose their license in one state and then go on to practice in another. And what we found in the public records that Karen, the reporter, was able to obtain is that, one, New Mexico did know the details of why Byrne had lost his license in New York before it gave him a license just a year after he lost it in New York.

And two, in talking with some of the people who run medical boards, it's clear that they really do rely a great degree on a trust system. You know, that is to say that they hope that doctors are honest on their applications when they apply for a medical license. And I just want to play you a another clip from one of those conversations. This is Lyle Kelsey. He's the executive director of the Oklahoma state medical board. He started in that position just before the board granted Byrne a medical license there.

LYLE KELSEY: We license almost 30,000 licensees and in 14 different professions. And you, you know, somewhere you have the hope that they're all being honest when they renew their license and answer questions.

SHAKERDGE: Do you think that hope is enough when it comes to a profession of people who are taking care of patients? Does that work out OK?

KELSEY: Well, I'm not so sure what your question is. Of course, you recognize that it's a learned profession, highly educated people. And you would presume by that that these people would be honest and forthright in answering questions. And occasionally, we may find out that somebody has lied on their application and that becomes then a fraudulent application. But I don't think there's anything wrong with hope.

WERTH: So, Scott, you hear him saying there isn't anything wrong with hope. But when we compared public records with how Byrne answered questions on several of his applications in several states, including Oklahoma, we found many instances where Byrne had made false statements and misrepresented the circumstances as to why New York had revoked his license.

DETROW: Were you able to talk directly to Byrne about all of this?

WERTH: Yeah. We tried many times to reach Dr. Byrne. We sent him questions by email. We tried to talk to him by phone. There were two instances in which we actually did reach him, but he hung up. And we also sent journalists to his places of work in the Bronx and in Amarillo, Texas. In Texas, a journalist showed up, but Byrne refused to speak to that person.

DETROW: Whether we want to admit it or not, there's a point in almost everybody's life where you put your life in the hands of a doctor, and you expect him or her to be an expert at what they're doing. And that's not always the case, as we're seeing here. What was your big takeaway from this investigation?

WERTH: Yeah. I think I'll quote from, you know, one of the patient safety experts that we spoke with in this series. And they said health care, you know, is an industry just like any other. And sometimes decisions are made for reasons other than patient safety. You know, a number of the people who we spoke with describe the economic pressures that might lead a medical board to grant a license to a doctor with a concerning track record or a hospital to hire that person.

You know, there are many hospitals in this country, whether they're in rural parts of New Mexico or in urban areas in New York City serving low-income communities, that struggle to recruit any kinds of specialists, right? The former head of nursing at a rural hospital where Byrne worked in Oklahoma told us that she couldn't recall there being an OB-GYN at the hospital or in this area before Byrne was hired. So there's an incentive to make that hire and perhaps overlook some of the concerning things. And it can be very difficult for patients to find that information out on their own.

DETROW: Yeah. That's WNYC investigative editor Christopher Werth. Christopher, thank you so much.

WERTH: Thanks, Scott.

DETROW: Imminent Danger was produced in partnership with the Pulitzer Center. You can listen to the whole series on the NYC NOW podcast. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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